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Add Taddio 1997
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Taddio ''et al''. (1995) (1997) studied the behavior of circumcised boys in comparison to the behavior of intact boys at the time of routine vaccination. Taddio ''et al''. (1995) reported:
<blockquote>
Male circumcision is the most common neonatal surgical procedure. It causes intense pain and measurable changes in behaviour that last up to 1 day. We found that circumcision status was associated with increased infant pain response to routine vaccination at 4-6 months. Circumcised boys had significantly longer crying bouts and higher pain scores. That both outcome measures, pain index, and cry duration, were influenced by circumcision lends credibility to our observations. During the second (HIB) vaccination, circumcision status was more clearly associated with the observed pain response than after DPT. The DPT injection might have had a priming effect in circumcised infants which led them to exhibit even more pain after the HIB injection. The effects of memory and reinforcement on later nocioceptive experience in neonates are not known. Because memory of pain is believed to be important in subsequent pain perception, and the main structures for memory are functional in the neonatal period, it is conceivable that pain from circumcision may have long-lasting effects on pain response and/or perception.<ref name="taddio1995">{{REFjournal
</blockquote>
Taddio ''et al''. (1997) followed with a larger second study in which circumcised boys were compared with intact boys at time of vaccination four to six months after birth. Three measures to determine pain were used. Once again circumcised boys showed greater response to the pain of vaccination than intact boys.
Taddio ''et al''. reasoned that:
<blockquote>
It is, therefore, possible that the greater vaccination response in the infants circumcised without anaesthesia may represent an <u>infant analogue of a post-traumatic stress disorder</u> triggered by a traumatic and painful event and re-experienced under similar circumstances of pain during vaccination.
</blockquote>
and concluded:
<blockquote>
The results of this study are consistent with studies of pain response in animals and behavioural studies in humans showing that injury and tissue damage sustained in infancy can cause sustained changes in central neural function, which persist after the wound has healed and influence behavioural responses to painful events months later. Pretreatment and postoperative management of neonatal circumcision pain is recommended based on these results. Investigation of the neurological basis of these effects is warranted.<ref name="taddio1997">{{REFjournal
|last=Taddio
|first=Anna
|author-link=
|last2=Katz
|first2=Joel
|author2-link=
|last3=Ilersich
|first3=A Lane
|author3-link=
|last4=Koren
|first4=Gideon
|author4-link=
|etal=no
|title=Effect of neonatal circumcision on pain response during subsequent routine vaccination
|trans-title=
|language=
|journal=Lancet
|location=
|date=1997-03-01
|volume=349
|issue=9052
|pages=599-603
|url=http://www.cirp.org/library/pain/taddio2/
|quote=
|pubmedID=9057731
|pubmedCID=
|DOI=10.1016/S0140-6736(96)10316-0
|accessdate=2019-12-08
}}</ref>
</blockquote>
{{REF}}